Professional Documents
Culture Documents
1882 Jervoise - Infection
1882 Jervoise - Infection
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REMAEKS
BY
MISS NIGHTINGALE
SECON D EDITION.
ITonbon;
1882.
PREFACE.
IDS^YORTH, HORNDEAK,
HiXTS,
J. CLARKE JERYOISE,
Magistrate and D.L. for the County, and Ude
M.P. for the Southern Division of the
County of Southampton.
A 2
—
INFECTION.
" have not a drop of blood left in my body, 1 don't feel better.
" I see clearly that I must die, but do let me die quietly."
On the 3rd May I moved an address to the Crown (Xo. 1,
• " It was one thingsay a few words there surrounded by kind friends, and
to
quite another to pet up in House of Commons where every one wislicd you to sit
tlie
its bearing not only on persons who were at liberty, but on a class of persons
—
whose case had been under discussion that evening viz., those who were
placed in confinement. Nothing could be more shocking, if the theory
alluded to in his notice of motion were true, than the idea that persons
locked up in gaols should find themselves subject to the influence of
infectious disorders.The hon. member referred to a tale written by a
French author about a poor leper and his sister, who were shut up in a
tower and condemned to a miserable life of seclusion on account of their
fearful malady. Their only companion was a little cur dog, and the sister
having died, the brother was left alone with the pet dog, which, however, the
authorities ordered to be destroyed, in order to prevent the infection from
being carried elsewhere and the wretched man at last committed suicide
;
disease was not infectious, so that it did come und^r the motion of the hon.
member. It was true that in the other House, Earl Granville said a great
many persons had died from it but this was a mistake. Earl Granville
;
was alluding to another disease which also existed in Russia, and which was
highly infectious. This disease broke out among cattle, and was communi-
cated to human beings and, according to the last reports, upwards of
;
70,000 cattle were killed by it during the year and 30,000 men. As to
the cattle plague, this was not the time for a cattle plague debate, the
proper occasion for which would be when a Bill was introduced on the
subject. He was sorry to say, however, that there had been recently a
fresh outbreak of cattle plague in London. The existence of the disease
here was suspected for some little time owing to the removal of cattle from
some dairies. At last it was discovered that the disease existed in one
London dairy where there were 39 cows, which all had the disease, and all
of which were killed. This happened in the preceding week, and he
trusted that the slaughter of these cattle had prevented the further spread
of the disease. With regard to contagious and infectious diseases, the
— a
two terms were treated pretty much as convertible but iufection was the
;
term, being, in fact, the genus, while contagion was the species. Infectious
diseases witc tliosc which were cuniiuunicatcd from man to man, or were
generated in the air, or by means external to man. Yellow fever was not
Contagious, though it was infectious and what pos.siblc harm, therefore,
;
was tliere in Dr. .Seaton's visit to the ship at the Mutherbank ? The disease
was communicated by the air and not by contact witli persons. Perhaps
the hon. member would say, Why. then, impose any quarantine?' The
'
was imposed, not through fear of the s))read of yellow fever, but in order
that our ships and merchandise should not be exposed to quarantine
abroad, and subjected to the loss which that would entail. The laws con-
nected with the comnmnication of diseases were pretty well known by
this time. There might be some few special disea.scs upon which addi-
tional knowledge was required. But surely the Health Ofhco, in which
there were two or three medical men of great scientific attainments, aflordod
a better means of investigation tlian that proposed by the hon. member —
Commission composed of a chemist and a lawyer. (A laugh), lie did not
know wliat would be the business of the lawyer, except, he supposed, to
impose the restrictions of law upon the spread of di.«;case. But the hon.
gentleman would sec that with men who had spent all their lives in the
investigation of the subject, and with all the appliances at their command,
the Privy Council had means at their disposal much better than the com-
mission which the hon. baronet recommended. The hon. baronet had
alluded to cholera. He was happy to say that upon this important subject
most careful and accurate investigations had been carried on, the results
had been tabulated, and in a few days a voluminous report would appear,
which, he trusted, would be satisfactory to the hon. baronet. There Avcrc
other points to which the hon. baronet had called attention, but, as he had
considerable difhculty in hearing the hon. gentlemen's remarks, he trusted
that would be sufficient excuse if he desisted from pursuing the subject
further." Times, Mmj -ilh, 1SG7.
The motion for an address was then withdrawn.
''
to weigh heavier? " suggested that the experiment sliould be
tried. I sliall, I am confident, be pardoned, if I am not
altogether acquitted, for having brought the subject, however
imperfectly, before Parliament and the country.
I have, from time to time, asked Questions in the House
of Commons'^ on the subject of the communication of disease
by the process of infection^ and I had intended to use the
Questions as landmarks to guide mc on my road, but speak-
ing without notes, the first reference I made to these
documents showed me that I could not read what a few
hours before, in the daylight, had been legible enough.
But I will not compromise by naming one who seconded
me (unasked) in the daring heresy of supposing that the
statement in the Sixth Report of the Medical Officer of
the Privy Council —" And though the present and other
" illustrations cannot increase knowledge (which has long
" been conclusive) with respect to the causation of disease "
— is not to be accepted as a dogma, or of suggesting that a
chemist and a lawyer might bo as good a tribunal to inquire
into the nature of the so-called infectious diseases of man
and beast, and to judge of the value of the evidence adduced,
as the two or three gentlemen connected loith the Board of
Healthy of great scientific attainments ^ loho had j)rettg well
ascertained the nature of cdl diseases, whether contagious or
infectious.
* Mr. Gladstone, "They (Questions) have now become a very serious, and I am
hound add, a very important part of the business, and therefore not frivolous or
to
trifling" (hear, hear). —
"Times," July 2nd, 1881.
—
10
and tlir" result Avas that the whole of the United Kingdom was i)Ut into
quarantine at all the Meiliterranean ports. This, and not any anticipated
danger from the importation of yellow fever, is the real reason why we
relegates the unhaiipy passengers in om- West India steamers to the Mother-
bank, Avhenever, during the homeward pa.ssage, a stoker dies of yellow
fever engendered by r\im, over-Avork, and miasma, Avhilst coaling at
St. Thomas's."'
11
''
All that we know is, nothing can be known,"
* I hate caused tliis beautiful story to be translated with a preface and appendix.
13
on the only living thing with which they are allowed toassociate,
a little dog which, on account of its ugliness, had been turned
out from other quarters, and had been forced to the leper's
lodgings for refuge. The leper encourages the officer to pick
some flowers which he cultivates, " as he will run no risk in
touching them," foralthough the leper loves to sow and water
the flowers, he never touches, for fear of contaminating
them. When the children come to rifle his little garden, he
withdraws into the old tower, " he might frighten or
lest
injure them/' and when they depart they look up towards
him and say, Good day, leper, laughingly," and that
''
rejoices him a little. The sister dies, and the leper stands
alone in the world, with no living thing to console him but
the little cur dog. The medical authorities, however, of the
town of Aosta, see danger in the dog, and considering it might
carry the "(/erws" of the disease among the inhabitants of
the town, the dog is stoned to death in sight of the leper,
whose grief at the moment only permitted him to see cruelty,
in what he avows was a just, though severe, order. He
meditates a crime, not revenge, but self destruction, for he
had contaminated the earth long enough, and wishes that it
may swallow him up and " leave no trace of his detestable
existence.'^ This story is a fiction founded on the facts of
that day, but they are also the facts of the present day, as
may be seen by the extract.
"LEPROSY.
"A report on leprosy by the Royal College of Physicians has been
prepared for Her Majesty's Secretary of State for the Colonies. It is a very
.
14
some British colonies, the slightest ascertained taint of the malady carries
with it a seclusion tantamount to banishment from the rest of the com-
munity, or even to perjx'tual detention in a lazaret. Enactments fur the
arrest and imprisonment of lepers have been proposed or passed even
within the last few years in some of our Indian colonics. In the villages
of Syria lepers are required to go to Damascus, or some other town where
there may be a public asylum and if they will not conform to this rule,
;
'they are made to live in a cave or hut outside the village, where they
remain in perpetual quarantine.' All such enactments or regulations
should be'abolished." Tiinrs, December 29th, 18G0.
service to those whom the fear or the presence of pulmonary disease drives to
seek an Italian winter, to call their attention to one of the modes in which
— !;
15
but should he chance to die there tranquilly in his bed, the necessity for
burning the furniture, for scraping, lime-whiting, and papering the walls,
arises from that sad and simple fact. The ground upon which such a
charge, the most exorbitant of any that has been manufactured for many a
long day, rests, is utterly untenable, and, of course, the demand should be
at once repudiated. At the same time a little care is needed to prevent
surprise, for in those cases in which a house or an apartment is taken by
agreement for any length of time, the legal document which binds the
contract may contain a clause to the effect that the tenant is expected to
pay the extortionate sum which we have named in case of death occurring
from consumption, and we notice the matter that the profession may put
clients on their guard." The Lancet,
" and easily satisfied in all sciences, are the foes of all
" inquiries into the mysteries of nature they are like the ;
16
very desirable.
" Such reasoning falls like an inverted cone,
AVanting its proper base to stand upon."
But let me
give a fact or two illustrative of the action of
quarantine. Supposing that the Vice-President of the Com-
mittee of Council on Education was not entirely correct in
saying, " Quarantine was instituted on commercial grounds
alone/'
• I revoke this statement. Its terrors are not defunct. The so-called Astrachan
Pl;i"uc hashad its commercial as well as political t.^rrors and '^anic fears to suit
Russian diplomacy and a British nobleman.
19
supplicating the gods and the captain the i/uanla-costd people were in a
;
—
worse panic, if possible shouted orders and counter orders, ran out a gun
and ran it in again, threatened, prayed, and cursed, as though doom was on
them. This horror of the cholera seemed to have become a madness in the
Greek mind. Our sailors gave the wretches the benefit of much good and
strong English, which, I fear, was sadly wasted, and would have been equally
so had it been equally good Greek, but I noticed that our guanliann was
stricken with fear at the bare idea of the vicinity of the infected ship.
What the extent of the contagion was we knew not, of course but the ;
hurrying and trepidation of the people on board and in the boat which
came alongside made it evident that something unusual was going on.
The boat lay far off, and the officers shouted very loudly and we heard;
afterwards from the quarantine boat that there were four or five dead of
cholera on board, whom they wanted to send on shore to be buried, but
this was refused as dangerous then to be permitted to sink them in the
;
sea— this was still less to be allowed. They begged for a doctor no one —
would go (juardiani even would not go on board, for any compensation,
;
and they rowed away, leaving her to her fate. We shortly after received
an intimation that by reason of this new arrival all ships in quarantine at
that time must stay fourteen days more Here was the ship of the
—
ancient mariner, in sooth anchored only, but with anchors almost useless
on that tranquil sea, the fiery sun above, and the glassy water below, and
nothing to'l)reak that awful monotony but the merciless quarantine-boat
coming to ask and refuse. We could see the people on the ship gather on
the forecastle and in the rigging, looking out to the land, which, brown
and dry as it was, was to them a refuge. The second and the third day
came, and the dead multiplied, until ten or a dozen corpses were on board.
Still no physician, no landing, no burial even and the plague stricken
;
ship and its dying cargo lay still under the August sun. The third day the
crew received permission to put the bodies overboard, tied with ropes, that
they might not drift away and carry to some accursed Greek community
the plague it merited. I may be unjust, but those days have made me
detest and al)hor the vei'y name of Syra and its people. We saw the dead
lowered overboard, one by one, and with glasses could see them floating
alongside, horrible to sight and fixncY.'"--C'ornhill Maijaz'uie for February,
1800.
B 2
— —
20
a captain, with a pest-house under his command, and he dare not move
here or there lest he should violate some law, and nobody is there to tell
him what course to pursue. So a thousand human beings are imprisoned
many hours longer than they need be, in the midst of death in its most
fearful forms.' For thirty-six hours this floating pest-house lay without
succour or message fmm the shore; the steerage was crowded with the
sick and the dying, and the dead towed in boats at the stern. These hundreds
of poor men and women, thus f >rced to cling to what they considered a
charnel-house, without proper medical aid, are constantly on the verge of
riot and mutiny, in order to force their way out from the poisonous ship.
The first supplies that came from the shore, we are assured by a passenger,
were three barrels of saw-dust When at length the sick are to be removed,
!
place where, after the weary voyage, the quarantine jiatient can step on
shore, and where the poor steerage passengers can escape the effluvia and
])oison generated in those close holds after a long crowding of human beings
together." Xcir York Tiincf, Mai/, 18G6.
21
in quarantine at Liverpool may not be, and may not he construed to be, an
indication of any disposition to return to the system on the part of this
country. In truth, the time of quarantine has passed away. It is now
recognized that of all methods of preventing the spread of infection none can
—
he more unwise as undoubtedly none can be more ungenerous than to —
intensify the disease where it already exists by keeping the victims shut
up together in the narrow walls wherein it hrst appeared, debarred from
all the chances of recovery that the succour of the rest of the world can
give, and at the same time to condemn those of them not yet infected to
the peril of a forced contact with those — —
and those only who are already
suffering from the infection. The mental torture of such a situation might
well be enough to induce disease even where there was no predisposition to
it. Quarantine regulations have been and are disappearing, one by one,
from the statute books of all enlightened European nations. The public
mind is apt to take very sudden and somewhat unreasoning alarm on
matters of this sort, and there does not appear to be ground for indulging
in panic at present but at any rate, if it should hereafter appear that the
;
cholera is to be expected —
of which we shall certainly have good warning
—
from the Continent it would be the wisest plan to render compulsory the
erection in every considerable seaport town of hospitals such as that at
Liverpool, where the sick can be properly attended, and have at least all
those chances of recovery which human skill and care can give, instead of
seeking to resort to the barliarous system of cutting oft' from them all
chance of recovery by keeping them cooped up together, and cut off" from
proper succour, in the narrow limits of their vessel. As regards the
'Helvetia,' the Tost' thinks the Privy Council have acted with prudence
'
and discretion, and trusts that they will not be induced to do more than
that, at any rate, in order to meet the fears which are so easily excited
upon slender grounds, and with so much difhculty allayed." Pall Mall
Gazette, May, 186<J.
The '•
safe side,''' however, was taken at Liverpool.
" The National Steam Navigation Company have resolved to burn all
the fittings and the beds on board the Helvetia at once, and also those
'
'
on the '
War Cloud and Jesse ]\Iunn,' as soon as their occupants are
'
'
removed. The emigrants' luggage has been landed and handed over to
them. All the vessels will be thoroughly fumigated." Times, May \7th,
1866.
—
22
23
"
When we see the disease breaking out on the same day, September 19th,
1865, at Cette, Aries, Aix, and Courbevoie on October 1st, at Nancy and
;
St. Cloud the 5th, at j\Ielun ; the 6th, at Caen and St. Germain ; appearing
;
disease itself, its seat, and its mode of propagation are quite opposed to all
the principles of action of contagion.
" A^o infection. —
Where are the ferments, the effluvia, the miasmata of
cholera'? No one has ever discovered the least trace of these mephitic
—
24
gasos, of those iiiicrozo:iii\'S, of which there has been so much talk. The
atmosphero has not the least been infected with antiscjttics and preparations
<it chlururcs, A'c,
under the pretext uf destroying these supposed microzoaires,
and neutralising the supposed gases, of which there never has been the
least trace discovered. Finally, have we not seen, and do we not every day
see, that cholera respects the most unhealthy jdaces, and devastates others
which are in the most perfect sanitary condition '.
—
" -Vo poison. We cannot help saying that in the embarrassment of
finding a means of propagation for cholera, and being determined that
there should be one, the contagionists have been obliged to declare that
there is poison, but the presence of this jioison has never been shown, nor
its nature explained.
''
—
\o ciinnift/ion. There is no emanation from the bodies of cholera
patients ;this would be equally impossible during life and after death.
''
])uring life the bodies are dried up and are coM, even below the
temperature of tlie surrounding atmosphere the laws of chemistry as well
;
even that it •came by the fresh water canal from Fell-el-Keber by the
iiiarket-W()men.' But as such is not the ease, our task is much more
diflicult we shall have to follow it in all its meanderings, its erratic
;
course, without any guide, in the liope of discovering something of its mode
of ])ri)pagation and its etiology.
"The disease always makes its api)earance in diflerent distant parts of
a country at the same moment, frequently even before it has visited the
neighbouring countries. It is impossible to trace out its direct mute. It
leajis fmm north to south, from east to west, in every direction, and often
to immense distances without to\u'hiiig the intermediate country.
" It is impossible to establish the filiation of the disease when it declares
itself suddenly in a city, in the centre of a country, where there has not
been one single case of cholera. Ca«es occur at the same instant in jilaees
not only the most distant from each other, but also without any possible
connnunication between the ])atients ; in the cells of jirisons, in convents,
in hospitals, il'c, »V'c., in the most healthy as well as in the most unliealthy
places ;amongst all classes of society, the rich and jioor the valid and the
;
invalid. Thus this terrible disease apjjcars to us to break through all the
laws tliat contagious diseases are subject to.
"Is it not then most unreasonaliie to inflict the rigours of quarantine
laws on nations, to interrupt the intercourse between people, and to create
terror, which never fails to s])read the disease /
''
Then as to the suj)posed ellicacy of disinfectants. Dr. Shrimpton thus
expresses himself :
25
'
From what has just been said upon the causes of this fever it may be well
understood that we should not be inclined to estimate among its preven-
tives the system of separation entailed by the quarantine laws, with their
train of hardships and inconveniences. * * '' * Experience has
shown that very little reliance is to be placed upon the disinfecting mix-
tures that have been proposed with the view of altering the constitution of
the atmosphere, and by this means destroying the malaria which may exist
in it.'
"We commend these opinions to the attention of the authorities who
have recently enforced quarantine regulations at this port to an almost
unprecedented extent and at the same time we would respectfully suggest
;
''
The water cholera theory
of the Pvegistrar-General is not yet accepted
by scientific men
as proved, for a good many reasons, of which we shall
probably hear more as the more deliberately worked out reports of the
medical officers of health and the special commissioners of the Privy
Council are completed and published. ^Meantime it has been a matter of
difficulty to merely practical and unscientific persons to understand how,
amongst a pojiulation of whom a very small proportion ever drink unboiled
water, the cholera should be so widely si)read by that agent. "Will the
jtrevalence of adulteration help to solve the difficulty ? Beer, we all know-
to be largely adulterated with unboiled water, and London milk equally or
more so. Even country milk, it appears from a statement in a medical
contemporary, is not free from admixture with water drawn from surface-
Avells suspiciously near to cesspools, and dungheaps, and drains. "We have
no hope of stopping tliis sophistication but may we appeal to the con-
;
26th, 1867 :—
" INFECTIOUS DISEASES.
" Sir J. C.Jervoise inquired of the Vice-President of Council on
Education whether his attention had been called to the report of the com-
mission on yellow fever at liiTmuda, 18.5(5 report of committee on yellow
;
fever at Bermuda, LsG4 report df the late epidemic of scarlet fever among
;
27
* A review at Aldershot was put off in consequence of Her Majesty the Queen
being advised of the danger.
—
28
to below.
THE CHOLERA.
"SiK J. jEiivoifB asked the Vice-President of the Committee of
C.
Council on Educutiou whether the attention of the medical olhccr of the
Privy Council had been directed to a statement in the Morning Star of ' '
the 25th of Octuher, 1865, that the Emperur and Eni]iress of the French
had visited the cholera hospitals at Paris, and that M. Gustavc Uirard had
made experiments in demonstration of the non-infectious nature of the
cholera.
"Mr. r)RrcE said that the medical officer of the Privy Council was
cognizant of the conduct of the illustrious personages in question, whuse
courage and humanity on that occasion had excited such general admiration.
He was also aware of the daring experiments made by M. Girard, who
had placed upon his tongue the moisture of the brow and the fur from the
tongue of a man who had died of Cholera. 13ut, in the first place, such an
experiment only proved the insusceptibility to that disease of M. Girard,
and by no means proved that the experiment might be tried with equal
safety by other persons. Even, if held conclusive on that point, it did not
in the slightest measure invalidate the position taken by the medical
officer of the Privy Council with respect to the infectiousness of that
disease. The hon. baronet had, moreover, overlooked the fact that, as the
French Government Avas at present strongly advocating quarantine pre-
cautions against cholera in the East, it might be presumed that their
medical advisers entertained the same opinion as the medical adviser of the
English Government on the subject of M. Girard's experiments." I'iiitcs,
30
"The Linslade Bench of Magistrates have just made the /Irs I conviction,
under the 38th section of this Act, which enacts that any ])erson suH'eriiig
'
from any (Idiujrroiis iiifectidtis disorder who wilfully exposes himself, without
proper precaution against spreading the said disorder, in any street, public
place, or public conveyance, shall, on conviction of such oftcnce before any
justice, be liable to Ajwiuil/y not exceeding £.3.' It appears the case was
taken up at the instance of the Aylcslntry Board uf (juardmns, who
proceeded under the above clause, against Emanuel Cook, of Wingrave,
under these circumstances :
— Cook had been for some time an inmate of
the '
roH(a</io>is uard,' or 'jusl-h-tiise,' attached to the Aylesbury Union
Workhouse, and was under treatment for small pox by Mr. linlnrl Ceili/,
the medical officer of that establishment. The man had expressed a desire
to go out and see his friends, but Mr. Ceely, being a/ <ijiiitiuu that such an
act would ueitlur /'arilil/ite the patient's recovery nor he conducive to the
public health, strictly forbade his leaving the premises. Regardless of this
veto, however. Cook managed to elude the observation of the parties in
charge of the pest-house, and escaped, proceeding while iu that condition
along the high road, through several populous villages, as far as Wingrave,
where he incauliotishi called at jjcople's houses, and, as they were aware
of his state, set the whole population in a terrible fritjht. lie was taken
back to the workhouse, but rejn'ated his ollence, which led the Guardians,
in the interest of the jiiiblic health, to institute the present prosecution.
The Bench severely commented on Cook's conduct, and as this Avas the first
hnown ease of the\ind wliich had come under the magisterial observation,
he was fiued in the mitigated penalty of 5s., and 12s. Gd. costs. The Bench
intimated their intention on the recurrence of any similar case to impose a
much heavier penalty." Times. Mttij 11//;, 18(57.
And I now hope all the parties, and the country with them,
are not " compromised."
It will be found that public health and public wealth arc
more properly " interchangeable terms " than infection and
contagion; and to seek security from precautions of quarantine
tends only to mislead, and sometimes to generate the very
malady against which it ))rofesses to guard. T avow myself,
32
INFECTIOUS DISEASES.
" Sir J. C. Jervoise asked the Secretary of State for the Home
Department Avhether the statement weekly report of the Registrar-
in the
General, Novem])er 17, l^fifj, that Dr. Kranklaiid had investigated some of
the physical properties of cholera-stuft" (cholerine) was exactly true; and
•whether it was the intention of Iler Majesty's Government to introduce
any measure tending to obviate the loss, alarm and injustice consequent
on the theory of the infectious nature of certain diseases, when unsupported
by demonstration.
' Mr. Walpole said he would not undertake to say whether the report
was scientifically true but as soon as the notice of the question was put
;
Frankland. who was a very eminent cliemist, was, no doubt, in the appendi.v
to the Registrar-General's report of JS'ovember last, and that he considered
it a very valuable document. Perhaps he (Mr. Walpole) had better read
the paragraph of the Registrar-General's letter, which would be a more
complete answer to the lion, gentleman's question I consider such
:
— '
publication tends to put the public on their guard, with a view to exercise
greater care in destroying what is sup])osed to increase the number of
cliolera cases.' I am ntit aware of any bill upon this subject which it may
be advisable for her Majesty's Government at present to offer to the con-
sideration of i^irliament."'
CHOLERA CONTAGION.
"
Sir J. Jervoise asked the Vice-President of the Committee of Council
on Education whether his attention had been called to the report of the
medical oOiccr <>{ tlic Privy Council (18G(i}, in wliich he states, pp. :50-40,
the mode in which cludera-contagium isg(>nerated whether tiie discoverer
;
not ; and whether the annual report of the medical otlicer, which was not
accessible to members till towards the end of July in the last, would be so
at an early period in this Session.
"Mr. CoHRY said the opinions expressed in the paragraph referred to
were not those of a single discoverer, but were the results of the investigation
of a number of scientilic men. With regard to the rei)ort, he could niit
hold out any hope that it would be laid ujion the table mucli earlier than
it was last year."
If only the nest, I shall not stand alone. One hundred years
ago Smollett was on the look-out for Halcyon's nests floating
on the sea off the coasts of Nice and Genoa, but he did not
succeed in finding one. He did, however, discover at j\Iont-
34
35
c 2
— — ——
36
" Reflecting that the operations of nature are generally uniform, <tc.,
I now discovered that the virus of cow pox was liable to undergo the
progressive changes from the same causes precisely as that of small pox,
&c., the specific quality being lost.
" Here the close analogy between the virus of small pux and of cow pox
becomes remarkably conspicuous ; since the former, when taken from a
recent pustule and immediately used, gives the perfect small pox to the
person on wh(»m it is inoculated but when taken in a far-advanced stage
;
room, the germs of disease are not sown broadcast over the
land ] for it is absurd to suppose that, with this transformation
of the substance, the shadow of infection woukl resist change.
Well, then, I ''
go by the facts that we know, to those we
wish to know," alw^ays supposing the "vital organised germ"
theory to be a myth.
In the year 1857, the Customs' Report stated that (in
38
'^
and rabbits are subject to this disorder, and may be the
" carriers of the contagion ; sheep dogs certainly can be the
" means of transmitting the virus; " and that " every writer
" of merit in Europe attributes this disease to the introduction
" of diseased animals across the Russian frontier, into Poland,
''
Hungary, Prussia, Pomerania, c*v:c. " and that '' it is a ;
''
malady that never has, and never will originate spon-
" taneously in this country?" Is there no connection between
the outbreak and shearing time ;
driving the sheep to the
wash, wetting them througli in running water, depriving
them of their fleece, and exposing them in this state to the
wet and cold of the summer 1 8G2 ? Is there nothing to be
learnt from the following extract ?
CLErxKENWl'LL
"Mr. AVilliain AVinbey, cattle salesman and dealer, of the Metropolitan
Cattle Market, was sunuiiuned before Mr. Cooke, at the instance of the
secretary of the Ifoyal Society for the Prevention of Cruelty to Animals,
charj^ed with cruelty to animals l>y cxiwsinpj sheep for sale at the Metro-
jKilitan Cattle Market without jiroper covering, they having been recently
shorn.
" Mr. Rickets, solicitor, of Frederick Street, Gray's Inn Road, instructed
by Mr. Love, prosecuted ; and Mr. Field, Solicitor, of Finchlcy, defended.
— — —
39
" Last week it was proved that the sheep were exposed in the cattle
market on a bleak, cold, and wet day, the ground being covered with snow,
without any clothing on them, the sheep having been recently shorn. To
prove that the defendant had been guilty of cruelty, Professor Spooner,
of the Royal Yeterinaiy College, was called, and he deposed as follows :
I consider the acts narrated are very cruel, and that the animals must have
suffered a great deal. I have examined meat from animals that have been
so exposed, and have found that it was very much deteriorated. The very
fact of the animals standing with their backs arched, their heads hanging
down, and shivering, would show that they were suffering great pain.
The skin of the sheep is highly sensitive and thin, and the removal of the
wool would expose the nerves. The present practice of shearing sheep in
cold weather is a most cruel one, and ought to be suppressed." April llth,
1867.
40
"llOCKHAMrTON.
" From our files of Rockhanipton papers, wc quote the following :
" XovEL Imtort. — One of the new arrivals bv the fJrcat Pacific lirought
ashore on Friday a monster Tom cat without submitting him to the
formality of any uflicial inspection. Fortunately, however, fur the ])eace of
the town, !Mr. -Macpherson, the Sheep and Cattle Inspector, seeing Turn on
tlie wharf, and knowing that a late regulation forbids the introduction of
any quadrupeds from Europe, arrested him on the spot, to the intense
disgust of the owner and a large mob of sympathising admirers of Grimal-
kin. The Inspector marched oft' his prisoner at some risk to himself from
the claws of the brute. On returning from the races, on Friday, he found
the owner of the cat and about 50 men and women at his house. The cat
was demanded, and a good deal of threatening language used. The
Inspector, however, was firm, and showed his authority to the belligerents,
who thereupon subsided ami submitted to the fate destined for their
favourite. He was ]»ut into a bucket of water, from which he sprang on to
the inspector's sliouldcrs, ami after a good deal of trouble was finally
drowned in another bucket. He was then consigned to the earth by his
late owner and admirers." Xorthcni Arijus.
41
42
*'
Contagious or infectious diseases shall be deemed to mean
''
the several diseases mentioned in schedule heretOj and such other
"diseases as may from time to time he declared to be contagious
'^
or infectious hj order of H. M. in Council;''^ a despotic
power to which tlie Privy Council is hardly entitled.
The claim to infallibility is again set up in a Bill pre-
sented by the Lord President to the House of Lords, l-itli
* This writer assorts the development of disease as the proof of infection. This
is merely begging the question.
43
Oil the 31st May Third Report appeared '' The pre-
a
—
" paration of this Eeport has, from its nature, devolved
''
mainly on the medical men of the Commission and their ;
47
Mr. Hay, the county inspector, was called on the 17th, and pronounced the
disease to be rinderpest. On tSaturday several of the other animals were
observed to be affected and on Tuesday the committee resolved to have all
;
the stock slaughtered, except the cows in the byres, which will be allowed
to remain until they show symptoms of the disease. The cause of the
outbreak on this farm, which is three miles west from Pitmillan, the last
centre of the disease in the parish of Foveran, is as yet unknown.
Scuts)iian.
that it is probable " that in the days of high winds and high
" temperature, with no rain, minute particles of infected matter
" were carried by the wind from the district of Fettercairn,
" scattered in the line of the wind, and took effect wherever
" they found a susceptible subject, which in every case was a
" cow or heifer in calf.
" If we are justified in tracing this outbreak to the infected
" centre of Fettercairn, we cannot resist the conclusions that
" we have in our midst, a disease so virulent that the germs
:
48
*'
retain their vitality, after being carried by the wind 30 or
" 40 miles, and so penetrating that it finds its way unaided,
" save by the wind; but in the Second Report of the Cattle
" Plague Commissioners, it is specially noticed that the
" disease has travelled commonly in a direction counter to
" that of the prevailing winds."
50
acting as carriers of the virus, because the Jaio does not take
There has been many a " grievous muiTain " in the land,
and many a "sore famine." Free Trade has mitigated the
latter and never aggravated the former. At a
visitation,
frightful cost we have been " stamping out " the cattle plague,
for two years, without success. The medicine failed from
thefirst, and so the proposed remedy is to double the dose
nothing in the reports from all parts of the world to justify the
segregation of lepers.
health and even the life of the child, the liberty of the father, the
rights of the citizen, and the sacredness of his home, based upon
these chimeras, shall have received their death-wound.
D 2
52
upon which infected manure has been put, and the fluid contents of
the manure pit or of the special receptacle for the nrine ; yards or
sheds in which cattle have been kept to tread down long straw, and
the whole of such straw and manure, as also the ground beneath
them paths and roads upon which diseased cattle have walked or
;
been carried ; fields and meadows upon which they have been
grazing all carts, carriages, trucks, and railway trucks in which
;
diseased cattle have been conveyed, and all the platforms, railings,
bridges, and boards upon which they have been moved thereto ;as
also all apparatus which has been used to pen, tie, lift, haul, lower
and fix them the clothes, and particularly shoes and boots, and ii'on-
;
pointed sticks of drivers and their dogs the apparel of all cattle-
;
visiting infected j^laces, ships and all parts of the platforms, stages,
stairs, and bridges, hoists and cranes used for enibarkuig and landing
the animals markets, and all sheds and pens and implements used
;
ments in them which have been employed ujoon sick cattle, as also
sundry parts or organs A^'hich come from sick animals killed in
slaughterhouses knackers' yards, trucks, or carts, horses, men, and
;
been drinking, or into which any portion of theii" excreta has had
any opportunity of flowing directly or indirectly all fodder, grass,
;
mangers of wood, iron, or stone leather collars and straps, ropes and
;
Ixiwo eaten and all such small articles of little value which can easily
;
coun;c without havincc previously been mixed and stirred with a liberal
amount of chloride of lime. When the place has thus been scrubbed,
until the water flows off clean, it is ready for effectual disinfection.
" 2— For this purpose a solution of chloride of lime in water, in
the proportion of one pound of the powder to one gallon of water, is
made. For the lair of one animal from six to ten gallons of such
fluid should be ])reparod. This fluid is now distributed over the
whole surface, to be disinfected gradually by squirting from a syringe,
or by pumping through a force-pump, gai'den-engine, or by ^^ate^ing
from a watering-pot or can with a linely-i)ierced rose. All woodwork,
stones, bricks, cement, mortar, all fixtures of whatever material,
should be well wettetl with the solution and immediately be scrubbed
with a hard brush. Floor and ceiling are also scrubbed, and the
whole is left in this wet state covered with the chloride of lime
solution for at least one hour, during which time care is taken that
no parts become dry.
—
" 3. As the chloride of lime and the ])roducts of its decompos-
ing action upon infectious matter may be hurtful to cattle, these
matters have to be carefully washed off by a second and final flushing.
For this too much water and too much scrubbing cannot be employed.
Care should be taken to a})i)ly the clean water always to the higliest
parts, so as to cause it to flow thence to the lower parts, and to wash
away the waste from the lower parts before applying any fresh water
to the upper parts.
—
" 4. Care should also be taken to rinse and flush every broom
which has worked away sediment and waste from the lower ])arts
into and through the gutters and drains before apjdying it again to
the clean upper parts. Care should also be taken that the working
persons should not step fi'om the dirty or i)ai'tially-clf'aned places on
to the clean ones, as this may suffice to bring infection back to the
disinfected place.
—
" 5. Lastly, all persons em|)loye(l in this work, having swept
and flushed the gutters with the same care as the laii's, are collected,
together with all the engines and tools which they used, as near as
possible to the sink or place of final egress of water from the premises,
and there disinfected as Avill be described.
" The tools, such as hooks, forks, spades, hoes, barrows, SiC, arc
scrubbed with the above solution of chloride of linio, and subse-
quently water, until clean; they ai-e then repeatedly wetted with the
solution, and after it has had time to disinfect the entire surface of
thom they arc washed clean and laid up or hung up to dry.
" The workmen then, having fiuislied tlie disinfection and flushing
of all objects and surfaces, eflect their own disinfection in the
following manner: —
They wash their boots most carefully with
chloride of lime and water, scraping the soles and scrubbing the
scams where the soles join the upper leather. They Avash theii-
hands and arms, and by means of ?lean rags or sponges they remove
;
57
any splashes from their clothes. After this they go indoors, I'emove
all clothes from head to foot, wash their bodies, and particularly
their hands, faces, hair and feet with plenty of soap and water, and
put on fresh clothes and linen. The clothes and linen which tliey
have taken off should be treated as infected, set to soak immediately
in boiling water, and afterwards disinfected, or in water containing
two ounces of chloride of lime to the gallon in solution, or containing
four ounces of Condy's red permanganate of potash fluid in solution
or the clothes and linen should be put in a copper and boiled, and
subsequently washed. All articles of little value which are much
soiled should be burned on a bright fire.
—
"^. Disinfection of Live Stock. l.--Live cattle may carry
infection in two ways: first, by being themselves infected with the
plague and rejiroducing the poison; and, secondly, by accidently
carrying the poison from other animals in a dormant state upon some
part of their sui-face, tlieir hair, and particularly their feet. These
latter animals may therefore infect others without being or becoming
themselves subjects of the plague. All persons, therefore, buying
new animals should disinfect them before allowing them to enter
their premises. In a similar manner, if in a stable there has been
a case of plague the healthy or apparently healthy animals should
all be disinfected.
—
"2. The mode in which live animals maybe disinfected con-
sists in washing them with disinfectant solutions of such strength as
will desti'oy the contagion without injuring the surface of the
animal. Asolution of two ounces of chloride of lime in a gallon of
water is a proper solution for washing the coat of animals. A
mixture of four ounces of Condy's red ^permanganate of potash fluid
with one gallon of water is also a ])roper disinfectant solution. For
full-sized coAvsand bullocks, t^-c, several gallons of either of these
solutions should be used. Great care should be taken to keep the
solution away from the eyes, nostrils, mouth, and tender parts.
When the entire surface is washed and disinfected, all disinfectant is
removed by the application of great quantities of clean tepid water to
all parts. The animal is given a warming and refreshing drink, and
is conducted by a clean attendant to the clean quarantine shed.
There it should receive fodder, both dry and green, and sop, and
plenty of pure cold water, and be rubbed dry with whisks of straAV
and hay.
"/''. The Quarantine Shed. — —
1. The quarantine shed is intended
to keep the new and suspected cattle separate for a jieriod of at least
ten days, in order to afford the security, to be obtained by obser-
vation alone, that it is not actually infected with plague. While,
therefore, disinfection of the surface of cattle removes one kind of
danger, another which cannot be removed can only be kept circum-
scribed or penned in, and this is done by the quarantine shed. But
the keeping of cattle in the quarantine shed would not disinfect its
58
surface with certainty even during a mucli longer period than ten
days ; disinfection of the siu'face, therefore, cannot supply the pre-
caution of the quarantine shed, and a rigorous quarantine cannot
supply the effect of suiface dLsinfection, Both jjrecautions are neces-
sary for perfect security, although either of them, without the other,
obviates a particular kind and a certain amount of danger.
—
" 2. The quarantine shed should be situated in an isolated part of
the premises. All manure and urine from it should flow and be
carried to a particular place separate and distant from the common
dung-heap, and be buried daily.
" The utmost cleanliness should be observed in the shed. All
tools, jiails, currycombs, &c., \ised in this shed shoiild bo used in it
exclusively and nowhere else. The person attending the quarantine
shed should not be allowed to go into the shed Avhere healthy stock is
kept, or permitted to approach healthy stock. No person attending
healthy stock should be permitted to a]i})roach quarantine cattle, or to
go near or into the quarantine shed. But should unfortunately only
one person be available for both duties, that person should be allowed
to approach quarantine cattle only when clothed in the safety-di'css
immediately described.
" G. The Safety Dress. — —
1. This consists of strong water boots
reaching up to the knees, well greased all over ; of a waterproof coat,
buttoned close all the way up in front, and closing tightly round the
neck and wrists. The head is to be covered with a cap wliich takes
the hair well in.
—
" 2. Every pei'son having occasion to visit sheds in which there
is diseased cattle, or suspected cattle, or ipiarantine cattle, should be
provided with the above dress, })ut it on when entering the place,
take it off when leaving the place, and have it disinfected imme-
diately. This precaution should be sti'ictly observed by all inspectors,
all veterinarians, or others called in to attend sick cattle, by all
dealers and Ijutchers entering sheds, yards, or meadows for the
purpose of sale or purchase, and by all other persons coming un the
premises on business in connection with cattle.
—
" 3. The owners of stock shoidd not allow any sti-ansjers to
enter their sheds, yards, or meadows, exce})t in disinfected safety-
dresses; and in case this should give rise to difliculties, they will do
well to have themselves one or two such safety-dresses at hand, and
to cause all persons whose business compels them to enter their sheds
to leave then* own boots behind, and put on the long boots, water-
proof coat, and si)ecial cap. Only thus can they hope to exclude all
ordinary and oVjvious chances of infection from their ])reviouslv
healthy sheds, yju-ds, and meadows.
" J[. Measures to he Tahn un Prc7nisrs irlicrc Plague has Actualli/
Ajyprarcd. — 1. When the ]>lague has actually appeared in any shcij,
yard, or jdace, the sick animal should at once be removed with all
due precautious. It is certainly the safest and best to poleaxe the
59
only to let the animals enter the shed, &c., again after it is completely
sweet and dry.
—
" 2. If, however, a proprietor is desirious of keeping a sick
animal because its illness does not appear sevei-e or fatal, he should
place it in a separate shed, which must not be the same as, or near to,
the quarantine shed, and be distant from all healthy animals, and so
situated that the prevailing wind does not blow from this hospital shed
to-\\-ards the healthy or quarantine shed. The water should also not
flow from this hospital shed towards the others, or the yard, or any
meadow, but should be carefully drained a^\'ay and sent off the
premises by a special sink.
—
" 3. To prevent the scattering of fteces by infected animals (and
also by suspected animals and all animals suftering from diarrhoea),
their tails should be so tied to one or other of their horns as to ])ro-
tect them against being soiled by the intestinal discharges, and to-
prevent them from distributing such discharges by the ceaseless
motions peculiar to these organs. The spattering of fteces should be
prevented by a copius supply of rough straw, with some sand, saw-
dust, or ashes placed behind and underneath the animal. The straw
and faeces should be dealt with as has been described. Animals affected
with plague or diarrhoja should not be led along the streets,
highroads, and paths, as they would be certain to drop infectious
faeces, which would then be distributed OA'er the entire leng-th of
these roads by the feet of men and animals, and the wheels of
vehiciles.
" 4.— The sick animals should be disinfected repeatedly; their
pens shoiild be cleaned and disinfected repeatedly during the coui-se
of the illness. This should 1)6 done by persons either guarded by
the safety-dress, or (and this is safest), by such as may not come into
contact with healthy cattle, or have to enter healthy sheds. All
tools, pails, fodder, &c., to be used in the hospital shed to be kept for
that purpose only, and ilever to be used with healthy, or quarantine,
or only suspected cattle.
" 5.— If the proprietor of any dead piece of cattle, whether it has
died naturally or been killed, should decide upon dismembering it
instead of burying it entire, and upon iitilizing the hide, horns,
tallow, and bones, he should disinfect the skin, horns, and hoofs, by
steeping them for one hour in a strong solution of chloride of lime,
containing lib. of the powder in each gallon of water, and afterwards
washing them. The tallow .should be thickly })0wdered with chloride
of lime all-over, and be sent directly to the boilers. It should not
be boiled in any vessel employed on the farm. Under all circimi-
stances, it is advisable to let this dismemberment of dead and fallen
cattle be performed at the knacker's yard.
—
60
'<
6. —
Flesh, l)lood, guts, lungs, and the bones of the head of
infected animals should not be tralficked witli, tvs they cannot easily
be disinfected. They should always bo buried.
" Disinfection of Mcadous, Fields, liocids, S^-c.
/. 1. Meadows— —
infectedby diseased cattle should be carefully cleaned of all dung, by
burying each dropping on the spot where it lies, cutting out the round
piece of turf with the dropping on it, and turning it upside down. The
grass on the entire meadow sliould then be cut and burned. It should
then be left without any cattle for at lca.st a month, including at
least two wet days.
" 2. —All roails, paths, streets of towns, or villages should be
carefully and frequently scavenged. All carts, vans, or waggons used
for carryingmanure should be watertight, caulked, and painted, and
should not be permitted to ooze and drop their fluid or semi-fluid
contents on the road over which they are drawn. They should be
kept clean and disinfected, as a precautionary measure, by the pro-
ceedings above desci'ibed.
in^ and washing the prevention -of the development, by the destruction
:
* In '• Rtiid and Tliink," .Tune 4tli, 1878, I siiirpi'Sted tliat Dr. Thudichiiiu and
" Safety Dress" in cases of
other physicians sliould comply witli the directions as to the
" Infectious Disease," in which, however, a lighter material might be permitted. J. C. J.
REMARKS
BY
MISS NIGHTINGALE,
ON A PAMPHLET ENTITLED
i6
INFECTION."
Anon,
1867.
62
REMAEKS.
of disease.
assumption that any public good can follow from any Acts of
Parliament, then the matter becomes very serious indeed ; and
the fact of such legislation being possible can only be con-
superstition.
Public Health Act, the Local Government Act, and all other
Local Acts for improving the public health, have been founded
on error.
This Pamphlet is the first protest made publicly against
one can only hope that it will open the eyes of other
members of the House of Commons to the course on which
they have entered.